Obama offers health fix, but impact here unclear

Daniza and Scott Wiseman's insurance policy was canceled effective Dec. 31, the day their baby is due.

Daniza and Scott Wiseman's insurance policy was canceled effective...

It'll be up to Texas insurers to decide whether to reinstate scores of health policies they terminated because of the Affordable Care Act - despite President Barack Obama's executive order Thursday giving them that option - because the state insurance commissioner, unlike others, has not prohibited cancellations.

After weeks of controversy, Obama said consumers could retain their existing health care plans if those policies continue to be offered until 2015. Regulators in some states, such as Washington, said they would not allow insurance companies to extend their policies.

After Obama's announcement, Texas Insurance Commissioner Julia Rathgeber issued a statement saying she'll watch to see how insurers handle reinstatements but doesn't intend to get involved in their business decisions. The state's Republican leadership has been outspoken in its opposition to the federal health care law.

"Because Texas is not enforcing the Affordable Care Act, it remains to be seen how President Obama's executive order will impact the marketplace and consumers," Rathgeber said. "Whether a company offers or withdraws a policy is a business decision for that company. We will be closely monitoring the impact of these latest developments on consumers and the industry."

It's unclear how many Texas plans have been canceled and whether insurers will reinstate them. Companies that make up more than half of the state's health insurance market, including Blue Cross and Blue Shield Texas, Aetna and Humana, said they were weighing their options.

Blue Cross Blue Shield spokeswoman Margaret Jarvis said the company would "comply with any new requirements" but didn't say whether any canceled policies would be reinstated. "We're reviewing today's announcement and determining our next steps," she said.

Other insurers, including Humana, Aetna and Assurant Health, issued statements saying they would work with customers, regulators and the administration to provide affordable coverage and update policies.

"We support efforts to allow people to keep what they have. However, we will need cooperation and expedited approval from state regulators to remove barriers that would make it difficult to make this change in such a short period of time," the Aetna statement said. "State regulators will need to allow us to update our policies and secure appropriate rates so we can get these plans back in the market."

Couple's 'nightmare'

Scott and Daniza Wiseman of Missouri City have been notified of cancellation. A letter from their carrier, Celtic Insurance Co. in Illinois, said the policy "is not fully compliant with the new health care reform laws" and it was necessary to cancel. The notice indicated they would have the option of purchasing coverage in the marketplace.

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Scott said he and his wife, who is eight months pregnant, don't know what's going to happen as a result of Obama's order. Their policy ends Dec. 31, the day Daniza is expected to give birth. It would cover a cesarean section if she needs one before the policy expires. In the meantime, the Wisemans bought a Blue Cross and Blue Shield plan.

Politicians and health care experts said it's too soon to know how the president's order will affect Texans like the Wisemans because it's unclear how many people have received policy termination notices

"We do know there have been a number of people who have been dropped for a number of reasons," said state Rep. John Smithee, R-Amarillo, who chairs the Texas House insurance committee. "For some, it's too little too late. They've already made other arrangements or the insurer may not bring back those policies. We don't know what good this is going to do."

Elena Marks, a health policy scholar at Rice University's Baker Institute, said people who expected their policies to end by Dec. 31 should contact their insurers to inquire about coverage options.

"I just don't have a feel for when the companies are going to say, 'Yes, we will continue this plan or no we won't,' " she said. "The next move is the companies'."

Marks said Obama's order could have a significant impact on insurers such as Blue Cross and Blue Shield, which offers dozens of plans in the federal health insurance marketplace.

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She added that the president's decision could affect marketplace participation, which already has lagged because of flaws with the healthcare.gov portal where consumers can buy coverage that begins on Jan. 1 and determine tax subsidies.

Earlier this week, the Obama administration released marketplace enrollment data showing that fewer than 3,000 Texans had selected health care plans between Oct. 1, when exchanges opened, and Nov. 2.

"Some (insurance companies) have invested heavily in the marketplaces working," Marks said. "They were hoping all of the people who were going to be terminated from their insurance plans would end up in the exchange - maybe not with their product, but they were probably hoping that."

Charles E. Begley, who teaches health policy at the University of Texas School of Public Health, said people who received cancellation notices should compare their plans to those offered in the marketplace because they might find better deals.

"Considering that many of these people can get better coverage - possibly even better coverage at lower cost - through the marketplace exchanges, they need to look into those," he said. "Now, that's the big dilemma because the website is not working. You really can't look into these at this time."